Meredith Rosol often uses her noise-canceling earbuds during family meals to block the sound of others eating. “Thanksgiving isn’t the easiest time,” she says.

(Meredith Rosol - THE WASHINGTON POST)

A giant holiday dinner, for most of us, is a bonding experience where family and friends break bread and share stories while stuffing ourselves silly with special food and drink.

For those with a rare, newly recognized disorder called misophonia, the mere thought of such a meal inspires only anxiety and dread. People with misophonia hate certain noises — termed trigger sounds — and respond with stress, anger, irritation and, in extreme cases, violent rage. Common triggers include eating noises, lip-smacking, pen clicking, tapping and typing.

All that chewing, chomping, slurping and clinking of silverware can drive a person with misophonia to avoid family gatherings altogether. And worse, feelings of aggression tend to be amplified if the sounds are coming from those with emotional ties to the sufferer, such as family members or significant others.

“I haven’t eaten with my parents, at least without earplugs, in over a decade,” says Meredith Rosol, a 25-year-old elementary school teacher from Baltimore who was diagnosed with misophonia two years ago after years of hypersensitivity to sound.

“I was 6 years old, and it started with my parents chewing at the dinner table,” she recalled. Her list of triggers grew longer with every year: chewing (especially foods with crunch), tapping, typing, heavy breathing, silverware clinking, foot shuffling. Even certain sights started bugging her, such as foot-shaking and fidgeting. At school, typical classroom noises — like that of chalk scraping against the blackboard or the hum of a radiator — made her skin crawl.

“It’s like a fight-or-flight response: Your muscles get tense, you’re on edge, your heart races, and you feel the urge to flee,” Rosol says.

The term misophonia, meaning “hatred of sound,” was coined in 2000 not for people who were afraid of sounds — such people are called phonophobic — but rather for those who strongly disliked certain noises. Set off by stimuli that vary from person to person, the reaction, sufferers say, is like being sucker-punched in the gut or repeatedly stung by bees.

In 2013, a group of Dutch psychiatrists laid out the condition’s diagnostic criteria and urged that it be classified as its own psychiatric disorder. (Misophonia is not currently in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, in part due to its being such a newly identified phenomenon.)

Even though misophonia is a new term, thousands of people have been describing its effects on them for years and joined such online support groups as Yahoo’s Selective Sound Sensitivity Group and Reddit.com’s misophonia subreddit.

No one knows what causes the condition, so designating a standard treatment has been problematic, but experts seem to agree that misophonia isn’t so much about the sounds themselves as about their context.

“Sometimes their responses are localized around certain people: They might be bothered by their mother’s chewing but not their brother’s,” says Miren Edelstein, a Ph.D student at the University of California at San Diego who has researched misophonia.

As part of a small study, Edelstein interviewed a number of self-identified misophonics and found that the fight-or-flight emotion arises only in specific circumstances. For example, they didn’t mind their own chewing or typing noises, or sounds made by animals or babies. A teacher of autistic children, Rosol says she doesn’t usually get triggered by her students, even in the bustling cafeteria.

Edelstein and her colleagues also hooked up electrodes to volunteers’ hands to verify that their aversion to certain sounds was real.

“Prior to our study, we only had anecdotal evidence that misophonia was a real thing,” she says. “So we wanted to take the first step in providing objective physiological evidence.”

Self-described misophonics listened to a series of sounds and rated their discomfort level for each one; so did volunteers who served as a control group. The electrodes measured the electrical conductance of their skin, a well-accepted measure of physiological arousal. Sweat glands in the hands are especially sensitive to emotional stimuli, and skin becomes a better conductor in the presence of more sweat.

When misophonics’ discomfort ratings were high — say, during a sound bite of gum chewing or chip eating — their skin conductance shot up. But when they heard more soothing sounds, such as rainfall, they did not have a sweat reaction. In other words, they aren’t likely to be lying about having that sudden negative emotional response kick in.

Where does this intense reaction come from, if it’s not caused by the noises alone?

“In my opinion, misophonia is a learned conditioned response,” says audiologist Natan Bauman, owner of the Hearing, Balance and Speech Center, which has several locations in Connecticut. “If we associate a given event — in this case, all those trigger sounds — with something that is perceived to be a danger, then we need to act on it accordingly.”

He has seen close to 100 misophonics in his private practice and doesn’t believe that misophonia is a hard-wired phenomenon. Rather, he thinks his patients at some point made a negative association with certain sounds, so negative that they have an impulsive reaction to them.

Regardless of its cause, misophonia makes life difficult for those who have it and for the people around them.

Rosol, whose sensitivity began when she was 6 years old and her parents’ chewing upset her, has found her own workarounds: a white-noise machine and earplugs in bed, and noise-canceling headphones at the gym and on public transportation.

At meals, she wears a single earplug and blocks the other ear with her hand when others start chewing loudly.

At Thanksgiving dinner this year, she used an earplug or two during the meal and specifically avoided sitting next to her parents. Because she can’t hear what’s being said, she usually doesn’t contribute to the conversations.

“Thanksgiving isn’t the easiest time,” Rosol says. “I usually finish up earlier than everyone, go to the kitchen to clear my plate, and wait in another room.”